Classification: Official
Publication reference: PRN01537

To:

• Integrated care boards:
  • primary care leads
  • chief executive officers
• NHS England regions:
  • ­regional directors
  • ­regional directors of commissioning
  • regional directors of primary care and public health
  • regional heads of primary care

Dear colleagues,

Financial implications and actions for integrated care boards (ICBs) following the mid-year updates to the 2024/25 GP contract

Following the government’s acceptance in full of the recommendations by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), we sent a letter on 2 August, 2024 outlining changes to the 2024/25 GP contract. The letter announced a separate, fully funded, ring-fenced addition to the Additional Roles Reimbursement Scheme (ARRS) for recently qualified GPs.

Since then, the government has agreed to fund a 6% uplift to the locum reimbursement maximum entitlements available under Part 4 of the Statement of Financial Entitlements. It has also agreed uplifts to primary care networks (PCN) entitlements and pay-related elements of the general practice workforce transformational (SDF) funding. All of which are to be backdated to 1 April 2024.

This letter sets out the financial implications of these decisions, details of the additional funding allocations issued on 30 September 2024 and the actions required of ICBs.

Additional funding allocations

The additional allocations issued on 30 September supplement the 2024/25 ICB primary medical care baseline allocations and are detailed in Appendix A.

As with the additional funding provided for contract updates at the start of 2024/25, these allocations are based on each ICB’s share of total recurrent primary medical care allocations for 2024/25.

As previously outlined, the GP contract has been amended to uplift the pay elements of the contract by 6%, backdated to 1 April 2024 (a further 4% in addition to the 2% already included in contract funding at the start of 2024/25). We provided ICBs and NHS England regional primary care finance leads further information about this change in an email on 15 August 2024.

The DDRB pay uplift has been implemented through an increase to the global sum, with payments backdated to 1 April 2024 in the September Primary Care Support England (PCSE) payment runs. The new global sum for 2024/25 is £112.50.

The additional allocations issued to ICBs on 30 September also support the new dispensing fee scales as detailed in Appendix A.

ICB responsibilities and actions for implementation

The 6% uplift to locum reimbursement rates per Part 4 of the Statement of Financial Entitlements

ICBs need to:

• review all claims paid since 1 April 2024, and where the amount spent by the practice exceeded the original maximum reimbursable, the payment must be uplifted to the lower of the new maximum rate or the amount paid by the practice
• make all future payments for any new or outstanding claims for locum reimbursements using the new maximum payment rates as set out in the updated Statement of Financial Entitlements

ICB colleagues have advised that the simplest way for ICB primary care finance teams to identify payments will be to:

• review the amounts charged to the relevant locum reimbursement subjectives and PCSE pay codes
• calculate the uplifts due on them accordingly (the list of subjectives is included in Appendix B)
• make backdated payments to cover the additional amounts due on any locum reimbursement claims paid from 1 April 2024 to date

ICB responsibilities for further payments to practices and PCNs

During September 2024, PCSE processed global sum adjustments to backdate payments to 1 April 2024 for all General Medical Services (GMS) practices and Personal Medical Services (PMS) practices that are paid global sum equivalent (“global sum-like”) payments. They also updated payments for September to the new rate of £112.50 per weighted patient (pwp). This new payment rate will continue for the remainder of 2024/25.

During November 2024, PCSE will calculate the backdated and future payments due to all PCNs within their remit. These payments relate to the uplifted PCN entitlements in accordance with the details set out in Table 1 on page 58 of the PCN DES specification.

For practices and PCNs not included in the PCSE’s payment runs, ICBs need to:

• calculate the backdated global sum payments for any practices that are paid global sum or global sum equivalent (“global sum-like”) payments
• make backdated payments as soon as is practical, along with the in-month payments that are to be paid at the new rate of £112.50 pwp
• continue paying these practices at the new rate for any further payments due in 2024/25
• calculate the backdated and future payments due to PCNs in relation to the uplifted PCN entitlements set out in Table 1 on page 58 of the PCN DES specification

Updates to 2024/25 primary care networks DES payments

Table 1 below shows that additional resources continue to be available for the Additional Roles Reimbursement Scheme (ARRS) to those originally agreed in 2019/20 (see row B). This gives a total of £1,441 million to cover non-GP roles within the scope of the scheme as set out in the 2024/25 Network Contract DES.

Table 1 – overview of funding for the Additional Roles Reimbursement Scheme (ARRS)

Guidance on the arrangements for 2024/25 for rows A and B of Table 1 are set out in the 2024/25 financial implications letter published on 28 March 2024.

The additional funding for GPs in the ARRS scheme, shown at row D of Table 1, is worth £82 million in 2024/25. NHS England holds this funding centrally.

ICBs will be able to draw their maximum share of the £82 million, using the same principles as for the main ARRS scheme for non-GP roles. Further guidance on the claims process and the implementation and operation of the new scheme are included in the updated version of the 2024/25 Network Contract DES specification. Appendix A details the maximum value of the funding available for each ICB.

Increases in primary medical care workforce SDF allocations

Given the DDRB uplift, ICBs may need to increase the payment or reimbursement rates for the pay-related GP workforce SDF lines, such as Fellowships, Targeted Enhanced Recruitment Scheme and local GP retention schemes. Additional allocations totalling £58m were issued to ICBs on 30 September, enabling them to backdate uplifts to the pay-related elements for transformational GP workforce programmes to 1 April 2024. Further details and guidance on this will be provided shortly.

In the meantime, if you have any other questions, please email the team at england.pcfinancegroup@nhs.net

Yours sincerely,

Keira Moulds, Deputy Director, General Practice Contract NHS England 

Appendix A – additional ICB allocations for 2024/25 and GPs in ARRS scheme maximum entitlements

Download copy of the Additional ICB allocations for 2024/25 and GPs in ARRS scheme maximum entitlements spreadsheet.

Appendix B – list of locum reimbursement subjectives

• 5216101R – C&M-PMS PCO Locum Adop/Pat/Mat
• 5216101T – C&M-PMS PCO Locum Sickness
• 5216101V – C&M-PMS PCO Locum Susp Drs
• 5216101Y – C&M-PMS PCO Locum Prol Study Leave
• 521610WJ – C&M-APMS PCO Locum Adop/Pat/Mat
• 521610WL – C&M-APMS PCO Locum Sickness
• 521610WN – C&M-APMS PCO Locum Susp Drs
• 521610WR – C&M-APMS PCO Locum Prol Study Leave
• 521610YS – C&M-GMS PCO Locum Adop/Pat/Mat
• 521610YU – C&M-GMS PCO Locum Sickness
• 521610YW – C&M-GMS PCO Locum Susp Drs
• 521610YZ   -C&M-GMS PCO Locum Prol Study Leave